Eye drop medications are one of the most common products found in household medicine cabinets. Whether used to treat dry eye, allergies, conjunctivitis, ocular inflammation, or glaucoma. Eye drop medication may also be prescribed following eye surgery in order to prevent infection or reduce inflammation.

To get the greatest benefit from eye drops, you need to use them properly. If used incorrectly or overused, eye drops can actually damage eye health.

If you’re struggling to use your eye drops as directed, don’t give up! Just follow these simple tips to obtain the greatest benefit from your eye drops and to minimize any side effects.

Tips For Properly Using Eye Drops

1. 1. 1. 1. Always read the label
            Many people have made the mistake of inserting the wrong product into their eyes. Eye drop bottles may easily get mixed up with ear drops or other medications. Such mix-ups can potentially damage your eyes, and even result in chemical burns. We actually had a patient who accidentally put crazy glue into their eye thinking it was a contact lens rewetting drop.
         2. Apply one drop at a time
            When you insert one drop of eye medication and then a second one, you are really not getting more into your eye. you eye can physically hold less than one drops, so the second drop is not effective. Also, some individuals need to use 2 different eye drop medications to treat their particular problem. If we put the second drop in before the first drop is absorbed, then we don’t get the benefit we hope to get. It is a good idea to wait 10 minutes between inserting the 2 medication so that they will be absorbed.
         3. Apply drops on the center of the eye
            When applying eye drops, aim for the middle part of the eye, but you can even close your eye and put the drop in toward your nose, and then open your eyes. The medication will still get into your eye. .
         4. Close your eyes
            When applying eye drops, aim for the middle part of the eye, but you can even close your eye and put the drop in toward your nose, and then open your eyes. The medication will still get into your eye. After you insert the medication, it is wise to keep your eyes shut for 2 minutes. That way, there is less reflex tearing and more contact time between your eye and the medication. It will have a better opportunity to be absorbed.
         5. Avoid blinking your eyes vigorously after applying eye drops
            Instead, gently close your eyes for a few moments or blink as you normally would. By blinking vigorously, you will end up pushing the eye drops out of your eye.
         6. Punctal Occlusion
            Your tears drain through a small canal into the back of the nose. The nose has many blood vessels.
            When you insert eye drops, the medication can then enter the tear system and rapidly absorb into the bloodstream. To prevent this from happening, place a soft pressure on the lower tear ducts (situated by the bridge of the nose) after applying the drops. Do this by gently pinching at the sides of your nose. Doing so will help reduce any potential side-effects, such as an increase in blood sugar or blood pressure (in the case of topical steroid drops).
         7. Avoid having the tip of the bottle touch your eye
            Always make sure you hold the bottle at least 1 inch away from your eye. If the tip does touch the eye, it may lead to infection, as the bacteria from your eye can contaminate the solution.
         8. Don’t mix eye drops
            If you have multiple prescriptions or use over-the-counter drops, apply them at different times during the day. Combining too many drops at once may reduce their effectiveness.

      Though applying eye drops may seem like a straightforward task, not everyone does it right. If you have questions or are having difficulty applying eye drops, speak with Dr. Roth at Family Eye Care in Old Bridge. You can reach us at 732-679-2020. We serve patients in Old Bridge, South River, South Amboy, East Brunswick, Manalapan, Monroe, Matwan, Marlboro, and throughout new Jersey.

Ever heard the saying “to sleep with one eye open”? It’s generally used as a metaphor when advising one to stay vigilant. But sleeping with eyes open is a common eye and sleep disorder known as nocturnal lagophthalmos. In fact, the National Sleep Foundation estimates that about 1 in 5 people sleep with their eyes open.

This condition is problematic because it can interfere with sleep and impact eye health. People may not get as much sleep, or sleep as soundly as they’d like, due to the pain and discomfort caused by the eyes drying out during the night.

Nocturnal lagophthalmos generally indicates an underlying medical condition, such as a thyroid problem or an autoimmune disorder. If upon waking you experience irritated, dry, tired, red, or painful eyes, or if you suspect you might be sleeping with your eyes open, speak with Dr. Moshe Roth and Dr. Steffani Tiomno at Family Eye Care today.

What Happens When You Sleep With Your Eyes Open?

People who have nocturnal lagophthalmos may not even know they have it. It is difficult to evaluate whether your eyes are closed when you’re actually asleep. However, some important indicators may point to the condition, including:

• Eyes that feel scratchy, irritated and dry
• Blurred vision
• Red eyes
• Eye pain
• Tired eyes

For those with nocturnal lagophthalmos, the eye loses the protection of a closed lid and becomes dehydrated, causing the tear layer to evaporate and the eyes to become dry. Nocturnal lagophthalmos also reduces the eye’s ability to discharge contaminants such as dust and debris that fall into the eye during the night. These contaminants can potentially lead to:

• Eye infections
• Corneal damage, such as corneal abrasion, sores and ulcers
• Eye dryness and irritation
• Poor quality sleep
• Loss of vision

Why Do We Close Our Eyes to Sleep?

There are several reasons why it’s important to close our eyes while we sleep. Closed eyelids block light, which stimulates the brain to wakefulness.

Closing our eyes also protects and lubricates the eyes while we sleep. If your eyelids don’t close, your eyes become more susceptible to dryness, infections, and debris that can scratch and damage the cornea.

Why do Certain People Sleep With Their Eyes Open?

There are a number of reasons people might sleep with their eyes open. The most common reasons for nocturnal lagophthalmos include:

Problems With Facial Nerves and Muscles

Issues with facial nerves and muscles surrounding the eyelid can cause the lid to remain open during sleep. Weakness in facial nerves can be attributed to several factors.

 

• Injury or trauma
• Stroke
• Tumor
• Bell’s palsy, a condition that causes temporary paralysis or weakness of facial

muscles.

• Autoimmune disorders and infections, such as Lyme disease, chickenpox, Guillain-Barre syndrome, mumps, and several others.
• Moebius syndrome, a rare condition that causes problems with cranial nerves.

Damaged Eyelids

Eyelids can become damaged as a result of surgery, injury or illness, making it difficult to fully close the eyes during sleep. Furthermore, a condition known as floppy eyelid syndrome can also interfere with eye closure, and is often associated with obstructive sleep apnea (OSA). OSA is commonly linked to eye diseases like glaucoma and optic neuropathy.

Thyroid-Related Eye Problems

A common symptom of Grave’s disease, a form of hypothyroidism, is protruding eyes. The bulging eyes, known as Graves’ ophthalmopathy, can prevent the eyes from closing.

Genetics

There also tends to be a genetic component to nocturnal lagophthalmos, as it often runs in families. Whatever the cause, the symptoms of nocturnal lagophthalmos are uncomfortable and the consequences can lead to ocular complications.

Can Nocturnal Lagophthalmos Be Treated?

This condition can be treated in several ways, depending on the underlying cause and severity of symptoms. Treatments include:

• Administering artificial tears throughout the day, providing a film of moisture around the eyes that protects them at night.

• Wearing an eye mask or goggles to protect the eyes from external debris and visual stimulation. These items are uniquely designed to generate moisture for the eyes while you sleep.

• Using a humidifier, which provides a moisture-rich environment to prevent your eyes from drying out.

• Wearing eyelid weights to help keep the eyelids closed.

• In acute cases, surgery may be recommended.

Make sure to consult your eye doctor before undertaking any of these treatments.

Because nocturnal lagophthalmos sometimes signals an underlying condition, it is especially important to contact Dr. Moshe Roth and Dr. Steffani Tiomno at Family Eye Care in Old Bridge for a proper diagnosis and to receive prompt treatment. If nocturnal lagophthalmos is left untreated for an extended period, patients risk seriously damaging their eyes and vision.

We look forward to re-opening for comprehensive eye examinations, BUT we are not there yet. We have placed many new procedures and precautions to prevent the spread of COVID-19, and to ensure everyone’s safety. Below are a few of the changes you should expect when you come in for your eye exam.

Expect the Following Changes at Family Eye Care in Old Bridge

You can expect to see the following changes in our office during your next appointment:

• We will be wearing a face mask, gloves, and eye shield or face-covering safety shield, while patients will be required to wear a face mask.

• We expect you to come in wearing your mask.
• We will give you gloves when you arrive. Please discard yours so we can help keep our office safe for our staff and for our other patients.
• We have modified our schedule so adhere to social distancing.
• Seating in our Reception Area has been changed to promote social distancing.
• If you aren’t feeling well or have been in contact with someone who is ill, we ask you to let us know prior to your visit, and we will postpone your appointment by two to three weeks. Our staff will be asking patients about COVID-19 symptoms such as fever or cough.
• We have implemented procedures to ensure that we disinfect office fixtures and equipment before and after each patient’s visit. Exam rooms will be completely disinfected between appointments.
• We will frequently wipe down counters, chairs, equipment, and doorknobs. In the dispensary, eyeglass frames will be promptly disinfected after use.
• We will utilize a large shield during the slit lamp part of the exam, which requires the nearest doctor-to-patient contact. The protective shield will prevent respiratory droplets from being spread. (The slit lamp shines light into the patient’s eye, enabling the doctors at Family Eye Care to examine the front part of the eye.
• Our Ultra-Wide Retinal Camera will take a photo of the Retina, the back part of your eye. During this period this is the only way to see your retina.

The only constant in life is change. COVID-19 has led to rapid changes across most industries, and optometry is no exception. We continue to adapt to this new reality, to ensure that our patients receive the care they need, in comfort and safety. .

We also see patients through Telehealth. Please call our office to arrange that.

If you have an eye emergency, such as blurred vision, pain, flashes or floaters, we will prioritize your visit. You may want to watch THIS video about the many types of eye emergencies we treat in our office

If you frames broke or are lost, we will do our best to help you.

Please call us at 732-679-2020. We are here to help.

When stay-at-home restrictions begin to lift in many areas, optometry practices will open their doors for routine care, and eye exams for glasses, contact lenses, and eye surgery will be offered once again.

Practices are implementing strict precautions to prevent the spread of COVID-19, and to ensure everyone’s safety. Below are a few of the changes you should expect when you come in for your eye exam.

Expect the Following Changes at Family Eye Care

Family Eye Care in Old Bridge has strict protocols in place to prevent the spread of coronavirus and other infections. You should expect the following during your next appointment:

• Your optometrist will wear a face mask, gloves, and eye shield or face-covering safety shield, while patients will be required to wear a face mask.

• You will need to wash or disinfect your hands upon entering the practice, as well as when you enter different rooms.

• Packed waiting rooms will be a thing of the past. We will be spacing out seating to reduce capacity, and scheduling appointments to limit patient interaction.

• If you aren’t feeling well or have been in contact with someone who is ill, we ask you to let us know prior to your visit, and we will postpone your appointment by two to three weeks.

• We will space out appointments in a way that will allow our staff to sterilize office fixtures and equipment before and after each patient’s visit. Exam rooms will be completely disinfected between appointments.

• We will frequently wipe down counters, chairs, equipment, and doorknobs. In the dispensary, eyeglass frames will be promptly disinfected after use.

• We will utilize a large shield during the slit lamp part of the exam, which requires the nearest doctor-to-patient contact. The protective shield will prevent respiratory droplets from being spread. (The slit lamp shines light into the patient’s eye, enabling Dr. Moshe Roth and Dr. Steffani Tiomno to examine the internal health of your eye.)

The only constant in life is change. COVID-19 has led to rapid changes across most industries, and optometry is no exception. We continue to adapt to this new reality, to ensure that our patients receive the care they need, in comfort and safety. .

Is your vision blurred? Are you seeing spots or floaters? Are your glasses broken? Do you need contact lenses? Contact Family Eye Care in Old Bridge today for help.

Viruses cause many infections, such as the flu, the common cold, conjunctivitis (pink eye) and coronavirus.

Especially now that the COVID-19 pandemic affects us all, it is important to be aware of good hygiene practices, especially for the eyes. The eyes are a doorway for infectious diseases. The good news is that you have the power to reduce your risk of contracting or transmitting a viral infection.

What Is a Virus?

A virus is a submicroscopic infectious agent that reproduces itself by invading a host cell. It takes over the cell and forces the host cell to make more virus. You can think of the virus as a “bully”. The cell now makes millions of new viral cells and they are sent throughout the body. Once we are infected, we feel sick, have a fever, sore limbs and other symptoms. Our immune system recognizes the virus as being foreign and fights against it.

How Does a Virus Travel Between Organisms?

For a virus to cause disease, it first must enter a body, called a target host. A target host can get infected directly, via infected droplets (such as when kissing), or indirectly, when coming into contact with droplets from a cough, sneeze, or tears left on a surface. Infected droplets enter the body through one of the mucous membranes, such as the eyes, nose or mouth.

Even if the infected person shows no symptoms, they can still be contagious. Depending on the virus, it can survive on a surface for some time and can be picked up from a doorknob or an elevator button. This is why practicing good hygiene is an effective way to prevent indirect viral transmission.

4 Crucial Eye Hygiene Practices

By implementing the following hygiene practices, you will better protect yourself and others from viral infection.

1. Routinely wash your hands

We all touch many surfaces throughout the day. If we’re not careful, we can catch an infection, particularly from hard surfaces like plastic and stainless steel.

Viruses can also be picked up while preparing and eating food; using the toilet; or handling an animal. It is very important to wash your hands, ideally for a minimum of 20 seconds with soap and water, in order to kill viruses (and bacteria) on the surface of your skin. If soap and water aren’t available, use an alcohol-based hand sanitizer.

2. Keep your hands off your face

Studies show that the average person touches their face up to 23 times per hour, and that the majority of contacts involve the eyes, nose and mouth. Doing so puts you at risk for getting a virus or transmitting the virus to another. Try to be conscious and avoid touching your face whenever possible.

3. Avoid rubbing your eyes

Rubbing your eyes is an instinctual response to tiredness or itchy eyes. When we rub our eyes, we stimulate tear production and that lubricates the eyes, and removes irritants. However, if your hands are unwashed, rubbing your eyes can put you at risk of contracting an infection, such as conjunctivitis or coronavirus. In fact, conjunctivitis has been linked to respiratory infections like the common cold, the flu, and COVID-19.

4. Use makeup with caution

Given the information provided above regarding infections, the following advice should come as no surprise:

• Don’t share your makeup with anyone else, whether for eyes, lips or face.
• Don’t use a cosmetic brush previously used by another when testing makeup products. Instead, request single-use applicators and wands.
• Don’t use a product past its expiration date.
• Don’t use the same makeup products after you’ve been sick or have had an eye infection.
• Don’t share face cloths or face towels with anyone else.

Dr. Roth at Family Eye Care is committed to helping you manage your long-term eye health. We, at Family Eye Care in Old Bridge, hope that you stay safe and take care of yourself and your loved ones.

Tears literally enable us to see. They lubricate our eyeballs and eyelids, thus preventing our eyes from dehydrating. They also provide a smooth surface for refracting light, supply oxygen, and are a vital component of the ocular defense system that protects against a range of pathogens. Below we’ll delve into the composition and types of tears, and further explain why they are so beneficial to our physical and emotional well-being.

Structure of Tears

Tears are made up of three layers: lipids, aqueous and mucous.

The lipid layer is the outermost layer and prevents the evaporation of tears. The lipids are produced by tiny glands in the eyelids called the meibomian glands.

The aqueous layer, which is the middle layer, makes up 95％ of our tears. This layer supplies nutrients to the cornea, prevents infection, and heals ocular damage. This layer is effectively made up of water and is produced by the lacrimal gland.

The mucous layer is the one closest to the eye. It coats the cornea and provides a level platform that allows for an even distribution of the tear film over the eye. This layer is produced by even smaller glands called goblet cells.

The Three Types of Tears

Tears are composed of water, salts, amino acids, antibodies and lysozymes (antibacterial enzymes). However, there are several types of tears, and their composition varies. For example, the tears we shed while crying are different from the tears that flood our eyes in the presence of irritants like onions, dust or allergies.

Humans produce the following three kinds of tears:

1. Basal – these tears are constantly at the front of the eyeball and form the liquid layer over the eyeball to keep it lubricated.

1. Reflex – these tears appear when the eye is irritated, such as when the eyes feel gritty or when we get dust, sand or other small foreign objects in our eyes.

1. Psychogenic – these tears are sparked by emotion. They possess a higher protein level than basal and reflex tears, which makes them thicker, causing them to stream more slowly. Psychogenic tears are made up of higher concentrations of stress hormones such as adrenocorticotropic hormone and leucine enkephalin (a natural painkiller). This suggests that emotional tears play an important role in balancing stress hormone levels.

Tears Serve the Following Functions

Prevent dryness
Tears prevent dryness by lubricating the surface of the eye. Each time we blink we spread this cushioning layer of tears across the front of the eyes.

Supply oxygen and nutrients
Oxygen and nutrients are delivered to the cornea through our tears.

Prevent infection
Not only do tears wash away foreign bodies that enter the eye, but they can also prevent infection thanks to an antibacterial property contained within tears called lysozyme. This antibacterial agent fights off the germs we pick up in our surroundings.

Heal ocular damage
Tears are made up of substances that heal damage to the surface of the eye. Damage can be caused by foreign objects and even high exposure to UV rays.

Create a smooth surface on the eye
Tears lubricate and smooth our eye’s surface, leading light to be correctly focused and enabling us to see clearly.

Remove Toxins
Emotional tears contain more toxic byproducts than reflex tears (caused by irritation), and can thus flush out many toxins and stress hormones.

Dull pain and improve mood
Crying for extended periods of time releases oxytocin and endorphins. These feel-good hormones can help diminish both physical and emotional pain. Once the endorphins are released, your body may enter a more relaxed stage, with oxytocin providing you with a sense of calm and well-being.

As you can see, tears are invaluable for clear vision, protecting your eyes, flushing out irritants, and soothing emotions.

If you feel that your eyes are not as comfortable or your vision is not as clear as usual, contact Dr. Moshe Roth and Dr. Steffani Tiomno at Family Eye Care in Old Bridge today.

Though it may seem harmless, rubbing your eyes is something many of us do from time to time. Doing so feels good because it stimulates tear flow and eye lubrication, which offers relief for dry eyes and helps remove dust and other irritants. Furthermore, rubbing your eyes can be therapeutic, as pressing down on your eyeball stimulates the vagus nerve, which decreases your heart rate, thus relieving stress.

So why do eye doctors advise against rubbing your eyes? That’s because rubbing your eyes poses a threat, especially now, as COVID-19 can be spread through the eyes’ mucous membranes. Moreover, rubbing can potentially damage your eyes’ structure and vision.

Why is Rubbing Your Eyes Harmful?

• Continuous eye rubbing in susceptible individuals can cause the cornea to thin and weaken, leading it to bulge forward and become more cone-like. This is known as keratoconus — a serious condition that can lead to distorted vision and ultimately the need for a corneal transplant or specialized contact lenses, such as scleral lenses.

• If you have a foreign object in your eye, your natural instinct is likely to rub it in an attempt to remove the object. However, this can potentially cause more damage as the object can scratch the cornea. Instead, try flushing it out with saline solution or artificial tears.

• From a hygienic perspective, it’s important to remember that your hands are covered in germs and bacteria. Therefore, sticking a finger that hasn’t been thoroughly washed with soap and water into your eyes can cause an infection, such as conjunctivitis, to flare up. Recent evidence shows that the coronavirus can also be transferred from the hands to the eyes.

• Rubbing is harmful to people with certain pre-existing eye conditions. If you have progressive myopia (short-sightedness caused by a lengthened eyeball) or glaucoma (a condition that damages the optic nerve), rubbing your eyes can exacerbate the condition and worsen eyesight. Eye rubbing is particularly bad for a glaucoma patient with already heightened eye pressure. It can engender nerve damage and permanent vision loss.

• Retinal tear or detachment can occur due to the heightened eye pressure caused by the rubbing.

• Excessive eye rubbing can negatively affect your appearance. It can cause tiny blood vessels to break, resulting in bloodshot eyes, dark circles and wrinkles around the eyes.

Why Do We Rub Our Eyes?

When your eyes are itchy, it is tempting to rub them. But rubbing releases histamines, which make the itching worse, which in turn leads to more aggressive eye rubbing.

Rubbing your eyes isn’t all bad. It releases more tears, which in turn causes the meibomian glands, situated within your eyelids, to secrete much-needed oil into our eyes. That adds moisture and protects our tears from evaporating.

However, if you frequently rub your eyes because they are dry or irritated, contact Dr. Moshe Roth and Dr. Steffani Tiomno immediately.

How to Stop Rubbing Your Eyes

Keep your eyes hydrated by using artificial tears or eye drops. They can be found over the counter at the pharmacy, and are especially effective against dry eyes. Certain eye drops, such as antihistamines and mast cell stabilizers, can be prescribed by Dr. Moshe Roth and Dr. Steffani Tiomno to help prevent the itchy feeling that leads you to instinctually rub your eyes. In more severe cases, such as in allergy sufferers, steroid eye drops can be used to avoid chronic eye rubbing.

Excessive eye rubbing, whether due to chronic dry eye, itchy eyes, or habit, should be addressed to prevent any ocular and vision damage. Contact Family Eye Care at Old Bridge to schedule a visit, determine the cause of your itchiness, and find out which drops to use in your specific case.